Noise exposure and children's blood pressure and heart rate: the RANCH project

Noise and Air Pollution as Risk Factors for Hypertension: Part I-Epidemiology

Traffic noise and air pollution are 2 major environmental health risk factors in urbanized societies that often occur together. Despite cooccurrence in urban settings, noise and air pollution have generally been studied independently, with many studies reporting a consistent effect on blood pressure for individual exposures. In the present reviews, we will discuss the epidemiology of air pollution and noise effects on arterial hypertension and cardiovascular disease (part I) and the underlying pathophysiology (part II). Both environmental stressors have been found to cause endothelial dysfunction, oxidative stress, vascular inflammation, circadian dysfunction, and activation of the autonomic nervous system, thereby facilitating the development of hypertension. We also discuss the effects of interventions, current gaps in knowledge, and future research tasks. From a societal and policy perspective, the health effects of both air pollution and traffic noise are observed well below the current guideline recommendations. To this end, an important goal for the future is to increase the acceptance of environmental risk factors as important modifiable cardiovascular risk factors, given their substantial impact on the burden of cardiovascular disease.

Household disorder and blood pressure in mother-child dyads: A brief report

High blood pressure (BP) is the leading risk factor for cardiovascular disease (CVD). Although factors outside the home, such as crime and noise, have been associated with high BP in women and children, it is unknown if disorder within the home (household disorder) influences BP. We tested the hypothesis that women and children with more household disorder would have higher BP, independent of age, race, sodium intake, and body mass index (BMI). This study was a secondary analysis of data from mother-child dyads (n = 216). Mothers were 87% African American, 34 ± 5 years old, with BMI 33.59 ± 9.43 kg/m². Children were 7 ± 2 (range: 4-10) years of age with BMI z score 0.60 ± 2.07. Household disorder was measured by the Confusion Hubbub and Order Scale. Mother-child dyads were assessed for weight, height, BP (adults), BP percentile (children), energy intake, and sodium intake. The relationship between household disorder and BP was evaluated using Pearson's partial correlation coefficients. In fully adjusted models, household disorder was positively associated with systolic BP for mothers (r = 0.15, p < .05) and tended to be positively associated with diastolic BP (r = 0.11, p = .10). For the children, household disorder was not associated with systolic or diastolic BP percentile. This study's results suggest that household disorder is positively associated with higher BP in adult women, but not their children. Nevertheless, these data suggest that interventions to address household disorder could benefit maternal BP and potentially improve long-term CVD outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Impact of Noise Exposure on Risk of Developing Stress-Related Health Effects Related to the Cardiovascular System: A Systematic Review and Meta-Analysis

Background

: Exposure to acute noise can cause an increase in biological stress reactions, which provides biological plausibility for a potential association between sustained noise exposure and stress-related health effects. However, the certainty in the evidence for an association between exposures to noise on short- and long-term biomarkers of stress has not been widely explored. The objective of this review was to evaluate the strength of evidence between noise exposure and changes in the biological parameters known to contribute to the development of stress-related adverse cardiovascular responses.

Materials and Methods

This systematic review comprises English language comparative studies available in PubMed, Cochrane Central, EMBASE, and CINAHL databases from January 1, 1980 to December 29, 2021. Where possible, random-effects meta-analyses were used to examine the effect of noise exposure from various sources on stress-related cardiovascular biomarkers. The risk of bias of individual studies was assessed using the risk of bias of nonrandomized studies of exposures instrument. The certainty of the body of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results

: The search identified 133 primary studies reporting on blood pressure, hypertension, heart rate, cardiac arrhythmia, vascular resistance, and cardiac output. Meta-analyses of blood pressure, hypertension, and heart rate suggested there may be signals of increased risk in response to a higher noise threshold or incrementally higher levels of noise. Across all outcomes, the certainty of the evidence was very low due to concerns with the risk of bias, inconsistency across exposure sources, populations, and studies and imprecision in the estimates of effects.

Conclusions

: This review identifies that exposure to higher levels of noise may increase the risk of some short- and long-term cardiovascular events; however, the certainty of the evidence was very low. This likely represents the inability to compare across the totality of the evidence for each outcome, underscoring the value of continued research in this area. Findings from this review may be used to inform policies of noise reduction or mitigation interventions.

Natural and built environments and blood pressure of Alpine schoolchildren

BACKGROUND

Early life environments may influence children's blood pressure (BP), but evidence on the combined effects of natural and built environment exposures is scarce. The present study investigates the associations of natural and built environment indicators, traffic noise, and air pollution with BP in children living in Alpine valleys.

METHODS

In 2004/2005, 1251 school children (8-12 years old) were sampled for a cross-sectional survey in several Austrian and Italian mountain valleys. Children's mothers completed a questionnaire. The outcomes of interest were systolic and diastolic BP measured with a calibrated oscillometric device. Indicators of land cover assigned to the residential and school coordinates within 100 and 1000 m included normalized difference vegetation index (NDVI), tree canopy cover, and a broader naturalness indicator titled distance to nature (D2N). The presence of a home garden was also measured via self-report. Imperviousness density served as a proxy for the built environment. Residential air pollution (NO₂) and noise (L_den) from traffic were calculated using bespoke modeling. NO₂, L_den, physical activity, and body mass index (BMI) were treated as mediating pathways.

RESULTS

Higher NDVI and tree cover levels in residential and school surroundings and home gardens were consistently associated with lower BP. The built environment was associated with higher BP. Counterintuitive inverse associations between NO₂ and L_den and BP were also found. Structural equation modeling showed that higher levels of greenspace and presence of a home garden were weakly associated with more outdoor play spaces, and in turn with lower BMI, and ultimately with lower BP.

CONCLUSIONS

Exposure to natural environments may help maintain normal BP in children, while built environment may increase children's BP. Outdoor play and less adiposity in greener areas may mediate some of these associations. Evidence on air pollution and noise remains controversial and difficult to explain.

Using mobile phones as light at night and noise measurement instruments: a validation test in real world conditions

Exposure to noise from road traffic and industries is known to be linked to various health dysfunctions, including hypertension, cardiovascular diseases and hearing loss. Exposure to artificial light at night (ALAN) is also increasingly recognized as being associated with ecosystem damage and various illnesses, including cancers, excessive weight gain and sleep disorders. However, measuring and monitoring these environmental risk factors by professional equipment are laborious and expensive, which impede large-scale research and various citizen science initiatives. In this study, we test a possibility that reliable noise and ALAN exposure estimates can be gathered using smartphones (SPs) sensors. To verify this assumption, we develop a standardized testing protocol, and use Andro-Sensor app, installed on three different Samsung Galaxy SPs - S7, S20FE5G, and SM520F, - to perform measurements of ALAN and noise in real-world conditions while comparing these measurements with measurements performed by professional (type 2) equipment - SL814 for noise and LX-1330B for illumination. The analysis of 3450 measurements, performed in two different locations in Israel, reveals that the SPs measurements and measurements performed by control instruments correlate strongly for noise (r = 0.76-0.94) and are nearly identical for ALAN (r = 0.998-0.999). The association between the two types of measurements is also found to be close to linear, with the slope of the trend line being close to 45° for ALAN and varying between 30° and 45° for noise, depending on the SPs used. Our conclusion is that the level of accuracy of ALAN measurements by SPs is greater for ALAN than for noise, which can make SPs a useful tool for large-scale ALAN studies that do not require the accuracy of professional instruments.

Effects of Nocturnal Aircraft Noise and Non-Acoustical Factors on Short-Term Annoyance in Primary School Children

Children are considered at higher risk for harmful noise effects due to their sensitive development phase. Here, we investigated the effects of nocturnal aircraft noise exposure on short-term annoyance assessed in the morning in 51 primary school children (8-10 years) living in the surrounding community of Cologne-Bonn Airport. Child-appropriate short-term annoyance assessments and associated non-acoustical variables were surveyed. Nocturnal aircraft noise exposure was recorded inside the children's bedrooms. Exposure-response models were calculated by using random effects logistic regression models. The present data were compared with those from a previous study near Cologne-Bonn Airport in adults using very similar methodology. Short-term annoyance reaction in children was not affected by the nocturnal aircraft noise exposure. Non-acoustical factors (e.g., the attitude that "aircraft are dangerous" or noise sensitivity), however, significantly impacted on children's short-term annoyance. In contrast to children, the probability of moderate to high annoyance in adults increased with the number of aircraft flyovers during the time in bed. It is concluded that short-term annoyance from nocturnal aircraft noise in children is mainly determined by non-acoustical factors. Unlike in adults, acoustical factors did not play a significant role.

[Epidemiological Studies on the Association between Chronic Exposure to Road Traffic Noise and Blood Pressure: A Systematic Review with Meta-Analyses]

AIM

The aim of this study was to review epidemiological studies on the association between chronic exposures to road traffic noise and prevalence of arterial hypertension as well as blood pressure by using meta-analyses.

METHODS

A systematic literature search in the databases Medline^® and Web of science™ as well as the database OpenGrey was conducted to identify suitable studies, namely epidemiological observational studies assessing objective exposures to road traffic noise at the subject's home place with analysis of their potential associations with arterial hypertension or blood pressure. Whenever possible, overall effects for the different relationships were estimated with meta-analyses. For statistical analyses R for windows was used.

RESULTS

A total of 31 eligible studies were identified. Meta-analyses were conducted for potential association between road traffic noise and prevalence of arterial hypertension in adults and for association with systolic and diastolic blood pressure in adults and children. There was a significant (p<0.01) increase of risk for arterial hypertension in adults when exposed to chronic road traffic noise with an increment of 7% per 5 dB(A). Overall effects for systolic blood pressure were positive but weak for children as well as adults without any statistical significance. For diastolic blood pressure there appeared to be no relationship with chronic exposure to road traffic noise in either of the two groups.

CONCLUSION

Considering the multiple methodological limitations of studies examined as well as the high level of heterogeneity in all random effects models, the estimated overall effects must be interpreted with caution. To examine potential associations between road traffic noise and arterial hypertension or measured blood pressure appropriately, more prospective cohort studies are necessary with precise assessments of noise exposure as well as clinical endpoints and with adjustments for relevant cofactors.

Associations between ambient air pollution and noise from road traffic with blood pressure and insulin resistance in children from Denmark

Supplemental Digital Content is available in the text.

Background:

Road traffic is a major source of air pollution and noise. Both exposures may contribute to increased blood pressure and metabolic disease; however, few studies have examined these relationships in children.

Objectives:

We aimed to investigate whether long-term exposures to air pollution and noise from road traffic were associated with increased blood pressure and insulin resistance in children.

Methods:

Cardiometabolic outcomes were derived from a follow-up examination of 629 children (10–15 years old) enrolled in the Danish National Birth Cohort. We evaluated associations with prenatal and postnatal residential exposure to nitrogen dioxide (NO₂) and noise from road traffic (L_den) using historical addresses and linear regression models.

Results:

A 10-unit increase in postnatal exposure to NO₂ and L_den was associated with a 0.31 (−0.87, 1.48) and 0.18 (−0.61, 0.96) mmHg changes in diastolic blood pressure, respectively. In contrast, both exposures were associated with decreased systolic blood pressure. After adjustment and mutual adjustment for NO₂, exposure to L_den was associated with a statistical significant decrease in systolic blood pressure both during prenatal and postnatal life, but the majority of the associations evaluated did not reach statistical significance. Inverse associations were observed for plasma fasting glucose, insulin, and HOMA of insulin resistance for both exposures, exposure windows, before and after adjustment.

Conclusions:

The findings do not support evidence of associations between long-term exposures to air pollution and road traffic noise, increased blood pressure, and a metabolic profile characteristic of increased risk for glucose intolerance or type 2 diabetes later in life.

Traffic noise and other determinants of blood pressure in adolescence

BACKGROUND

Exposure to traffic noise has been associated with hypertension in adults but the evidence in adolescents is limited. We investigated long-term road traffic noise exposure, maternal occupational noise during pregnancy and other factors in relation to blood pressure and prehypertension at 16 years of age.

METHODS

Systolic and diastolic blood pressure were measured in 2597 adolescents from the Swedish BAMSE birth cohort. Levels of road traffic noise were estimated at home addresses during lifetime and for the mother during pregnancy as well as maternal occupational noise exposure during pregnancy. Exposure to NO_x from local sources was also assessed. Associations between noise or NO_x exposure and blood pressure or prehypertension were analysed using linear and logistic regression.

RESULTS

The prevalence of prehypertension was higher among males and in those with overweight, low physical activity or overweight mothers. No strong or consistent associations were observed between pre- or postnatal exposure to road traffic noise and blood pressure at 16 years of age. However, inverse associations were suggested for systolic or diastolic blood pressure and prehypertension, which reached statistical significance among males (OR 0.80 per 10 dB L_den, 95% CI 0.65-0.99) and those with maternal occupational noise exposure ≥ 70 dB L_Aeq8h (OR 0.60, 95% CI 0.41-0.87). On the other hand, occupational noise exposure during pregnancy tended to increase systolic blood pressure and prehypertension risk in adolescence. No associations were seen for NO_x exposure.

CONCLUSION

No conclusive associations were observed between pre- or postnatal noise exposure and blood pressure or prehypertension in adolescents.

Perinatal and childhood exposure to environmental chemicals and blood pressure in children: a review of literature 2007-2017

Exposure to environmental chemicals during periods of renal development from embryogenesis to birth and through childhood can inform critical windows of nephrotoxicity, including changes in childhood blood pressure. This review assessed recent studies that examined the relationship of air pollution, metals, and other organic pollutants with children's blood pressure outcomes. We restricted this review to peer-reviewed studies published in English between January 2007 and July 2017. We identified a total of 36 articles that estimated associations with childhood blood pressure, of which 14 studies examined the effects of air pollution, 10 examined metals, and 12 examined other organic pollutants including phthalates (n = 4), Bisphenol A (n = 3), polychlorinated biphenols (n = 2), organophosphate pesticides (n = 2), or perfluoroalkyl acids (n = 1). Similar to the established relationship between tobacco smoke exposure and childhood blood pressure, the majority of studies that examined air pollutants, particularly exposure to PM10 and PM2.5, reported associations with increased childhood blood pressure. The literature reported conflicting evidence for metals, and putative evidence of the effects of exposure to phthalates, Bisphenol A, polychlorinated biphenols, and pesticides. Overall, our review underscores the need for additional studies that assess the impact of nephrotoxicant exposure during early life, particularly the perinatal period, and blood pressure in childhood.

Environmental stressors and cardio-metabolic disease: part I-epidemiologic evidence supporting a role for noise and air pollution and effects of mitigation strategies

Traffic noise and air pollution together represent the two most important environmental risk factors in urbanized societies. The first of this two-part review discusses the epidemiologic evidence in support of the existence of an association between these risk factors with cardiovascular and metabolic disease. While independent effects of these risk factors have now clearly been shown, recent studies also suggest that the two exposures may interact with each other and with traditional risk factors such as hypertension and type 2 diabetes. From a societal and policy perspective, the health effects of both air pollution and traffic noise are observed for exposures well below the thresholds currently accepted as being safe. Current gaps in knowledge, effects of intervention and their impact on cardiovascular disease, will be discussed in the last section of this review. Increased awareness of the societal burden posed by these novel risk factors and acknowledgement in traditional risk factor guidelines may intensify the efforts required for effective legislation to reduce air pollution and noise.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Cardiovascular and Metabolic Effects: A Summary

To update the current state of evidence and assess its quality, we conducted a systematic review on the effects of environmental noise exposure on the cardio-metabolic systems as input for the new WHO environmental noise guidelines for the European Region. We identified 600 references relating to studies on effects of noise from road, rail and air traffic, and wind turbines on the cardio-metabolic system, published between January 2000 and August 2015. Only 61 studies, investigating different end points, included information enabling estimation of exposure response relationships. These studies were used for meta-analyses, and assessments of the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). A majority of the studies concerned traffic noise and hypertension, but most were cross-sectional and suffering from a high risk of bias. The most comprehensive evidence was available for road traffic noise and Ischeamic Heart Diseases (IHD). Combining the results of 7 longitudinal studies revealed a Relative Risk (RR) of 1.08 (95% CI: 1.01-1.15) per 10 dB (LDEN) for the association between road traffic noise and the incidence of IHD. We rated the quality of this evidence as high. Only a few studies reported on the association between transportation noise and stroke, diabetes, and/or obesity. The quality of evidence for these associations was rated from moderate to very low, depending on transportation noise source and outcome. For a comprehensive assessment of the impact of noise exposure on the cardiovascular and metabolic system, we need more and better quality evidence, primarily based on longitudinal studies.

Aviation Noise Impacts: State of the Science

Noise is defined as “unwanted sound.” Aircraft noise is one, if not the most detrimental environmental effect of aviation. It can cause community annoyance, disrupt sleep, adversely affect academic performance of children, and could increase the risk for cardiovascular disease of people living in the vicinity of airports. In some airports, noise constrains air traffic growth. This consensus paper was prepared by the Impacts of Science Group of the Committee for Aviation Environmental Protection of the International Civil Aviation Organization and summarizes the state of the science of noise effects research in the areas of noise measurement and prediction, community annoyance, children’s learning, sleep disturbance, and health. It also briefly discusses civilian supersonic aircraft as a future source of aviation noise.

Developing a data-driven spatial approach to assessment of neighbourhood influences on the spatial distribution of myocardial infarction

BACKGROUND

There is a growing understanding of the role played by 'neighbourhood' in influencing health status. Various neighbourhood characteristics-such as socioeconomic environment, availability of amenities, and social cohesion, may be combined-and this could contribute to rising health inequalities. This study aims to combine a data-driven approach with clustering analysis techniques, to investigate neighbourhood characteristics that may explain the geographical distribution of the onset of myocardial infarction (MI) risk.

METHODS

All MI events in patients aged 35-74 years occurring in the Strasbourg metropolitan area (SMA), from January 1, 2000 to December 31, 2007 were obtained from the Bas-Rhin coronary heart disease register. All cases were geocoded to the census block for the residential address. Each areal unit, characterized by contextual neighbourhood profile, included socioeconomic environment, availability of amenities (including leisure centres, libraries and parks, and transport) and psychosocial environment as well as specific annual rates standardized (per 100,000 inhabitants). A spatial scan statistic implemented in SaTScan was then used to identify statistically significant spatial clusters of high and low risk of MI.

RESULT

MI incidence was non-randomly spatially distributed, with a cluster of high risk of MI in the northern part of the SMA [relative risk (RR) = 1.70, p = 0.001] and a cluster of low risk of MI located in the first and second periphery of SMA (RR 0.04, p value  =  0.001). Our findings suggest that the location of low MI risk is characterized by a high socioeconomic level and a low level of access to various amenities; conversely, the location of high MI risk is characterized by a high level of socioeconomic deprivation-despite the fact that inhabitants have good access to the local recreational and leisure infrastructure.

CONCLUSION

Our data-driven approach highlights how the different contextual dimensions were inter-combined in the SMA. Our spatial approach allowed us to identify the neighbourhood characteristics of inhabitants living within a cluster of high versus low MI risk. Therefore, spatial data-driven analyses of routinely-collected data georeferenced by various sources may serve to guide policymakers in defining and promoting targeted actions at fine spatial level.

Children's blood pressure and its association with road traffic noise exposure - A systematic review with meta-analysis

BACKGROUND

Primary and synthetic research on road traffic noise (RTN) and blood pressure (BP) is more common for adults than it is for children and adolescents. Given the conflicting evidence from primary studies, this study aimed to conduct an up-to-date systematic review with meta-analysis of the association between RTN and children's BP, by using advanced statistical techniques, to take into account the heterogeneity in primary studies.

METHODS

MEDLINE (PubMed), EMBASE (ScienceDirect with filters), and the Internet (Google) were searched (last update: July 21, 2016) in English, Spanish, and Russian. Thirteen articles (total n=8 770) were included in the systematic review and 37 effect size estimates were pooled in different meta-analyses under the quality effects model.

RESULTS

Results showed 0.48mmHg (95% CI: -0.87, 1.83) increase in systolic blood pressure (SBP) and 0.22mmHg (95% CI: -0.64, 1.07) in diastolic blood pressure (DBP) per 5dB increase in RTN at school/kindergarten; and 0.20mmHg (95% CI: -0.30, 0.71) increase in SBP and 0.03mmHg (95% CI: -0.18, 0.25) in DBP per 5dB increase in RTN at home. There was high heterogeneity in the first three models and evidence of publication bias in the first. The following categorical and linear factors were significant effect modifiers in different exposure - outcome scenarios: country where the study was conducted, the mode of noise assessment, the mode of BP measurement, the type of reported effect size estimate, the overall quality score of the estimate, the minimum number of BP readings, and children's mean age.

CONCLUSIONS

All evidence considered, the observed association between RTN and BP is weak and further flattened by methodological issues of primary studies, but its long-term consequences should not be ignored.

Noise Pollution and Arterial Hypertension

Noise exposure modifies the function of multiple organs and systems. Acute noise exposure - both in laboratory settings where traffic noise is simulated and in real-life working environments - can cause increases in blood pressure, heart rate and cardiac output. This review examines the effects of noise pollution on the cardiovascular system, with a particular focus on non-auditory effects such as noise-induced arterial hypertension.

Road traffic noise, blood pressure and heart rate: Pooled analyses of harmonized data from 88,336 participants

INTRODUCTION

Exposure to road traffic noise may increase blood pressure and heart rate. It is unclear to what extent exposure to air pollution may influence this relationship. We investigated associations between noise, blood pressure and heart rate, with harmonized data from three European cohorts, while taking into account exposure to air pollution.

METHODS

Road traffic noise exposure was assessed using a European noise model based on the Common Noise Assessment Methods in Europe framework (CNOSSOS-EU). Exposure to air pollution was estimated using a European-wide land use regression model. Blood pressure and heart rate were obtained by trained clinical professionals. Pooled cross-sectional analyses of harmonized data were conducted at the individual level and with random-effects meta-analyses.

RESULTS

We analyzed data from 88,336 participants, across the three participating cohorts (mean age 47.0 (±13.9) years). Each 10dB(A) increase in noise was associated with a 0.93 (95% CI 0.76;1.11) bpm increase in heart rate, but with a decrease in blood pressure of 0.01 (95% CI -0.24;0.23) mmHg for systolic and 0.38 (95% CI -0.53; -0.24) mmHg for diastolic blood pressure. Adjustments for PM10 or NO2 attenuated the associations, but remained significant for DBP and HR. Results for BP differed by cohort, with negative associations with noise in LifeLines, no significant associations in EPIC-Oxford, and positive associations with noise >60dB(A) in HUNT3.

CONCLUSIONS

Our study suggests that road traffic noise may be related to increased heart rate. No consistent evidence for a relation between noise and blood pressure was found.

Study of physio-psychological effects on traffic wardens due to traffic noise pollution; exposure-effect relation

BACKGROUND

Noise pollution has increased to alarming extent in most of the urban areas in Pakistan. It is assumed even more perilous than air and water pollution due to its direct acute and chronic physio-psychological effects. The objective of this study is to analyze and evaluate the psychological and physiological effects caused by traffic noise on traffic wardens and to find relation type between exposure time and effect.

METHODS

Three wardens check posts near roads were selected for survey in Taxila and Islamabad cities of Pakistan. Survey conducted included noise measurements at aforementioned check posts for one month and Performa based interviews of traffic wardens.

RESULTS AND CONCLUSIONS

Analysis of results showed that noise levels varied between 85-106 dB hence violating OSHA regulations. Major psychological effects found in wardens were aggravated depression 58%, stress 65%, public conflict 71%, irritation and annoyance 54%, behavioral affects 59% and speech interference 56%. Physiological effects found were hypertension 87%, muscle tension 64%, exhaustion 48%, low performance levels 55%, concentration loss 93%, hearing impairment 69%, headache 74% and cardiovascular issue 71%. Relation between exposure time and effects were evaluated by using simple regression test in excel. Percentage of psychological and physiological effects in wardens varied with the exposure time; aggravated depression (R(2) = 0.946, P = 0.133), stress suffering (R(2) = 0.014, P = 0.173), public conflict (R(2) = 0.946, P = 0.133), irritation and annoyance (R(2) = 0.371, P = 0.137), behavioral affects (R(2) = 0.596, P = 0.0616) and speech interference (R(2) = 0.355, P = 0.445), hypertension (R(2) = 0.96, P = 0.00095) and cardiovascular issue (R(2) = 0.775, P = 0.044).

Environmental noise and sleep disturbances: A threat to health?

Environmental noise, especially that caused by transportation means, is viewed as a significant cause of sleep disturbances. Poor sleep causes endocrine and metabolic measurable perturbations and is associated with a number of cardiometabolic, psychiatric and social negative outcomes both in adults and children. Nocturnal environmental noise also provokes measurable biological changes in the form of a stress response, and clearly affects sleep architecture, as well as subjective sleep quality. These sleep perturbations are similar in their nature to those observed in endogenous sleep disorders. Apart from these measurable effects and the subjective feeling of disturbed sleep, people who struggle with nocturnal environmental noise often also suffer the next day from daytime sleepiness and tiredness, annoyance, mood changes as well as decreased well-being and cognitive performance. But there is also emerging evidence that these short-term effects of environmental noise, particularly when the exposure is nocturnal, may be followed by long-term adverse cardiometabolic outcomes. Nocturnal environmental noise may be the most worrying form of noise pollution in terms of its health consequences because of its synergistic direct and indirect (through sleep disturbances acting as a mediator) influence on biological systems. Duration and quality of sleep should thus be regarded as risk factors or markers significantly influenced by the environment and possibly amenable to modification through both education and counseling as well as through measures of public health. One of the means that should be proposed is avoidance at all costs of sleep disruptions caused by environmental noise.

Nighttime aircraft noise impairs endothelial function and increases blood pressure in patients with or at high risk for coronary artery disease

Aims

Epidemiological studies suggest the existence of a relationship between aircraft noise exposure and increased risk for myocardial infarction and stroke. Patients with established coronary artery disease and endothelial dysfunction are known to have more future cardiovascular events. We therefore tested the effects of nocturnal aircraft noise on endothelial function in patients with or at high risk for coronary artery disease.

Methods

60 Patients (50p 1–3 vessels disease; 10p with a high Framingham Score of 23 %) were exposed in random and blinded order to aircraft noise and no noise conditions. Noise was simulated in the patients’ bedroom and consisted of 60 events during one night. Polygraphy was recorded during study nights, endothelial function (flow-mediated dilation of the brachial artery), questionnaires and blood sampling were performed on the morning after each study night.

Results

The mean sound pressure levels L_eq(3) measured were 46.9 ± 2.0 dB(A) in the Noise 60 nights and 39.2 ± 3.1 dB(A) in the control nights. Subjective sleep quality was markedly reduced by noise from 5.8 ± 2.0 to 3.7 ± 2.2 (p < 0.001). FMD was significantly reduced (from 9.6 ± 4.3 to 7.9 ± 3.7 %; p < 0.001) and systolic blood pressure was increased (from 129.5 ± 16.5 to 133.6 ± 17.9 mmHg; p = 0.030) by noise. The adverse vascular effects of noise were independent from sleep quality and self-reported noise sensitivity.

Conclusions

Nighttime aircraft noise markedly impairs endothelial function in patients with or at risk for cardiovascular disease. These vascular effects appear to be independent from annoyance and attitude towards noise and may explain in part the cardiovascular side effects of nighttime aircraft noise.

Cardiovascular effects of environmental noise exposure

The role of noise as an environmental pollutant and its impact on health are being increasingly recognized. Beyond its effects on the auditory system, noise causes annoyance and disturbs sleep, and it impairs cognitive performance. Furthermore, evidence from epidemiologic studies demonstrates that environmental noise is associated with an increased incidence of arterial hypertension, myocardial infarction, and stroke. Both observational and experimental studies indicate that in particular night-time noise can cause disruptions of sleep structure, vegetative arousals (e.g. increases of blood pressure and heart rate) and increases in stress hormone levels and oxidative stress, which in turn may result in endothelial dysfunction and arterial hypertension. This review focuses on the cardiovascular consequences of environmental noise exposure and stresses the importance of noise mitigation strategies for public health.

The associations between traffic-related air pollution and noise with blood pressure in children: results from the GINIplus and LISAplus studies

Although traffic emits both air pollution and noise, studies jointly examining the effects of both of these exposures on blood pressure (BP) in children are scarce. We investigated associations between land-use regression modeled long-term traffic-related air pollution and BP in 2368 children aged 10 years from Germany (1454 from Munich and 914 from Wesel). We also studied this association with adjustment of long-term noise exposure (defined as day-evening-night noise indicator "Lden" and night noise indicator "Lnight") in a subgroup of 605 children from Munich inner city. In the overall analysis including 2368 children, NO2, PM2.5 mass (particles with aerodynamic diameters below 2.5μm), PM10 mass (particles with aerodynamic diameters below 10μm) and PM2.5 absorbance were not associated with BP. When restricting the analysis to the subgroup of children with noise information (N=605), a significant association between NO2 and diastolic BP was observed (-0.88 (95% confidence interval: -1.67, -0.08)). However, upon adjusting the models for noise exposure, only noise remained independently and significantly positively associated with diastolic BP. Diastolic BP increased by 0.50 (-0.03, 1.02), 0.59 (0.05, 1.13), 0.55 (0.03, 1.07), and 0.58 (0.05, 1.11)mmHg for every five decibel increase in Lden and by 0.59 (-0.05, 1.22), 0.69 (0.04, 1.33), 0.64 (0.02, 1.27), and 0.68 (0.05, 1.32)mmHg for every five decibel increase in Lnight, in different models of NO2, PM2.5 mass, PM10 mass and PM2.5 absorbance as the main exposure, respectively. In conclusion, air pollution was not consistently associated with BP with adjustment for noise, noise was independently and positively associated with BP in children.

Traffic-related air pollution and noise and children's blood pressure: results from the PIAMA birth cohort study

AIMS

Elevation of a child's blood pressure may cause possible health risks in later life. There is evidence for adverse effects of exposure to air pollution and noise on blood pressure in adults. Little is known about these associations in children. We investigated the associations of air pollution and noise exposure with blood pressure in 12-year-olds.

METHODS

Blood pressure was measured at age 12 years in 1432 participants of the PIAMA birth cohort study. Annual average exposure to traffic-related air pollution [NO2, mass concentrations of particulate matter with diameters of less than 2.5 µm (PM2.5) and less than 10 µm (PM10), and PM2.5 absorbance] at the participants' home and school addresses at the time of blood pressure measurements was estimated by land-use regression models. Air pollution exposure on the days preceding blood pressure measurements was estimated from routine air monitoring data. Long-term noise exposure was assessed by linking addresses to modelled equivalent road traffic noise levels. Associations of exposures with blood pressure were analysed by linear regression. Effects are presented for an interquartile range increase in exposure.

RESULTS

Long-term exposure to NO2 and PM2.5 absorbance were associated with increased diastolic blood pressure, in children who lived at the same address since birth [adjusted mean difference (95% confidence interval) [mmHg] 0.83 (0.06 to 1.61) and 0.75 (-0.08 to 1.58), respectively], but not with systolic blood pressure. We found no association of blood pressure with short-term air pollution or noise exposure.

CONCLUSIONS

Long-term exposure to traffic-related air pollution may increase diastolic blood pressure in children.

An epidemiological prospective study of children's health and annoyance reactions to aircraft noise exposure in South Africa

The purpose of this study was to investigate health and annoyance reactions to change in chronic exposure to aircraft noise on a sample of South African children. It was the intention of this study to examine if effects of noise on health and annoyance can be demonstrated. If so, whether such effects persist over time, or whether such effects are reversible after the cessation of exposure to noise. A cohort of 732 children with a mean age of 11.1 (range = 8–14) participated at baseline measurements in Wave 1 (2009), and 649 (mean age = 12.3; range = 9–15) and 174 (mean age = 13.3; range = 10–16) children were reassessed in Wave 2 (2010) and Wave 3 (2011) after the relocation of the airport, respectively. The findings revealed that the children who were exposed to chronic aircraft noise continued to experience significantly higher annoyance than their counterparts in all the waves at school, and only in Wave 1 and Wave 2 at home. Aircraft noise exposure did not have adverse effects on the children’s self-reported health outcomes. Taken together, these findings suggest that chronic exposure to aircraft noise may have a lasting impact on children’s annoyance, but not on their subjective health rating. This is one of the first longitudinal studies of this nature in the African continent to make use of an opportunity resulting from the relocation of airport.

The ecological context of soundscapes for children's blood pressure

Although the majority of studies on community noise levels and children's physiological stress responses are positive, effect sizes vary considerably, and some studies do not confirm these effects. Employing a contextual perspective congruent with soundscapes, a carefully constructed sample of children (N = 115, M = 10.1 yr) living in households in relatively high (>60 dBA) or low (<50 dBA) noise areas created by proximity to major traffic arterials in Austria was reanalyzed. Several personal and environmental factors known to affect resting cardiovascular parameters measured under well-controlled, clinical conditions were incorporated into the analyses. Children with premature births and elevated chronic stress (i.e., overnight cortisol) were more susceptible to adverse blood pressure responses to road traffic noise. Residence in a multi-dwelling unit as well as standardized assessments of perceived quietness of the area did not modify the traffic noise impacts but each had its own, independent effect on resting blood pressure. A primary air pollutant associated with traffic volume (NO2) had no influence on any of these results. The scope of environmental noise assessment and management would benefit from incorporation of a more contextualized approach as suggested by the soundscape perspective.

Creation of synthetic homogeneous neighbourhoods using zone design algorithms to explore relationships between asthma and deprivation in Strasbourg, France

The concept of 'neighbourhood' as a unit of analysis has received considerable research attention over the last decade. Many of these studies raise the question of the influence of local characteristics on variations in health and more recently, researchers have sought to understand how the neighbourhood can influence individual health through individual behaviour. Relatively few studies discuss the question of the borders and definition of a neighbourhood but we know that the results from health or population datasets are very sensitive to how zones are constructed - part of the Modifiable Areal Unit Problem (MAUP). In reality, we know that neighbourhoods are not constrained by artificial statistical boundaries, but rather exist as complex multi-dimensional living communities. This paper tries to better represent the reality on the ground of these communities to better inform studies of health. In this work, we have developed an experimental approach for the automated design of neighbourhoods using a small tessellated cell as a basic building block. Using the software AZTool, we considered population, shape and homogeneity constraints to develop a highly innovative approach to zone construction. The paper reports the challenges and compromises involved in building these new synthetic neighbourhoods. We provide a fully worked example of how our new synthetic homogeneous zones perform using data from Strasbourg, France. We examine data on Asthma reported through calls to the emergency services, and compare these rates with an index of multiple deprivation (NDI) which we have constructed and reported elsewhere. Higher correlations between Asthma and NDI were found using our newly constructed synthetic zones than using the existing French census areas of similar size. The significance of our work is that we show that careful construction of neighbourhoods - which we claim are more realistic than census areas - can greatly aid unpacking our understanding of neighbourhood relationships between health and the social and physical environments.

Traffic noise and blood pressure in low-socioeconomic status, African-American urban schoolchildren

The primary aim of this field study was to investigate the relationships among residential noise exposure at home and at school and blood pressure in low-socioeconomic status African-American children. Children were recruited from Boys and Girls Clubs in a mid-sized, Northeastern city. The sample consisted of 250 schoolchildren (128 boys and 122 girls) aged 6-14 years. Each child was interviewed prior to anthropometric and blood pressure measurement. An oscillometric monitor was used for measurement of resting blood pressure. Correlation analysis in the overall sample showed no significant relationship between noise exposure and children's blood pressure. No interactions were found between noise at home and at schools as well as orientation of bedroom and/or living room and noise at home with blood pressure. A sub-sample of children was also examined by adding the orientation of bedroom and living room as inclusion criteria (n = 128), and there was an interaction between noise exposure and age on systolic blood pressure. In younger children aged 6-10 years, a significant positive relation was found between noise levels at homes and systolic blood pressure, controlling for body mass index (B = 0.48, 95% C.I. = 0.07 -0.88, p = 0.02).

Does traffic-related air pollution explain associations of aircraft and road traffic noise exposure on children's health and cognition? A secondary analysis of the United Kingdom sample from the RANCH project

The authors examined whether air pollution at school (nitrogen dioxide) is associated with poorer child cognition and health and whether adjustment for air pollution explains or moderates previously observed associations between aircraft and road traffic noise at school and children's cognition in the 2001–2003 Road Traffic and Aircraft Noise Exposure and Children's Cognition and Health (RANCH) project. This secondary analysis of a subsample of the United Kingdom RANCH sample examined 719 children who were 9–10 years of age from 22 schools around London's Heathrow airport for whom air pollution data were available. Data were analyzed using multilevel modeling. Air pollution exposure levels at school were moderate, were not associated with a range of cognitive and health outcomes, and did not account for or moderate associations between noise exposure and cognition. Aircraft noise exposure at school was significantly associated with poorer recognition memory and conceptual recall memory after adjustment for nitrogen dioxide levels. Aircraft noise exposure was also associated with poorer reading comprehension and information recall memory after adjustment for nitrogen dioxide levels. Road traffic noise was not associated with cognition or health before or after adjustment for air pollution. Moderate levels of air pollution do not appear to confound associations of noise on cognition and health, but further studies of higher air pollution levels are needed.

The influence of different movements on ambulatory blood pressure in hypertensive subacute stroke patients

OBJECTIVE

This study evaluated variation in blood pressure (BP) in hypertensive subacute stroke patients performing eight different types of active movement, and variations in BP over time.

METHODS

The study included 35 subacute stroke patients (60 - 74 years old) and 15 age-matched healthy volunteers. Ambulatory systolic and diastolic BP was measured over 4 consecutive days, before and during active movement.

RESULTS

The greatest effect of the different active movements in stroke patients was on mean systolic BP variability (BPV). There was a significant difference in systolic and diastolic BPV between stroke patients at different time-points and compared with healthy volunteers. Systolic BPV during shifting from the ward to the rehabilitation centre was significantly higher than for all other active movements. Mean systolic BPVs during the sessions on the first and second days were significantly higher than for the sessions on the third and fourth days in stroke patients and compared with healthy volunteers.

CONCLUSIONS

Systolic BP was found to be increased in hypertensive subacute stroke patients during their first and/or second attempts at performing active movements. Therapists should consider the BP of hypertensive subacute stroke patients during these first two attempts, especially for activities involving the patient moving from the ward to the rehabilitation centre.

Transportation noise and blood pressure in a population-based sample of adults

BACKGROUND

There is some evidence for an association between traffic noise and ischemic heart disease; however, associations with blood pressure have been inconsistent, and little is known about health effects of railway noise.

OBJECTIVES

We aimed to investigate the effects of railway and traffic noise exposure on blood pressure; a secondary aim was to address potentially susceptible subpopulations.

METHODS

We performed adjusted linear regression analyses using data from 6,450 participants of the second survey of the Swiss Study on Air Pollution and Lung Disease in Adults (SAPALDIA 2) to estimate the associations of daytime and nighttime railway and traffic noise (A-weighted decibels) with systolic blood pressure (SBP) and diastolic blood pressure (DBP; millimeters of mercury). Noise data were provided by the Federal Office for the Environment. Stratified analyses by self-reported hypertension, cardiovascular disease (CVD), and diabetes were performed.

RESULTS

Mean noise exposure during the day and night was 51 dB(A) and 39 dB(A) for traffic noise, respectively, and 19 dB(A) and 17 dB(A) for railway noise. Adjusted regression models yielded significant effect estimates for a 10 dB(A) increase in railway noise during the night [SBP β = 0.84; 95% confidence interval (CI): 0.22, 1.46; DBP β = 0.44; 95% CI: 0.06, 0.81] and day (SBP β = 0.60; 95% CI: 0.07, 1.13). Additional adjustment for nitrogen dioxide left effect estimates almost unchanged. Stronger associations were estimated for participants with chronic disease. Significant associations with traffic noise were seen only among participants with diabetes.

CONCLUSION

We found evidence of an adverse effect of railway noise on blood pressure in this cohort population. Traffic noise was associated with higher blood pressure only in diabetics, possibly due to low exposure levels. The study results imply more severe health effects by transportation noise in vulnerable populations, such as adults with hypertension, diabetes, or CVD.

Indoor environment and children's health: recent developments in chemical, biological, physical and social aspects

Much research is being carried out into indoor exposure to harmful agents. This review focused on the impact on children's health, taking a broad approach to the indoor environment and including chemical, microbial, physical and social aspects. Papers published from 2006 onwards were reviewed, with regards to scientific context. Most of publications dealt with chemical exposure. Apart from the ongoing issue of combustion by-products, most of these papers concerned semi volatile organic compounds (such as phthalates). These may be associated with neurotoxic, reprotoxic or respiratory effects and may, therefore, be of particular interest so far as children are concerned. In a lesser extent, volatile organic compounds (such as aldehydes) that have mainly respiratory effects are still studied. Assessing exposure to metals is still of concern, with increasing interest in bioaccessibility. Most of the papers on microbial exposure focused on respiratory tract infections, especially asthma linked to allergens and bio-aerosols. Physical exposure includes noise and electromagnetic fields, and articles dealt with the auditory and non auditory effects of noise. Articles on radiofrequency electromagnetic fields mainly concerned questions about non-thermal effects and papers on extremely low-frequency magnetic fields focused on the characterization of exposure. The impact of the indoor environment on children's health cannot be assessed merely by considering the effect of these different types of exposure: this review highlights new findings and also discusses the interactions between agents in indoor environments and also with social aspects.

Epidemiological studies on noise and blood pressure in children: Observations and suggestions

OBJECTIVE

The goal of this review was to investigate methodological differences in studies on the effects of aircraft or road-traffic noise on blood pressure (BP) of urban children, emphasizing the similarities and differences in blood pressure measurements.

METHODS

A literature search has identified eight peer-reviewed studies, four conference proceedings and one PhD thesis on the effects of aircraft or road-traffic noise on children's blood pressure published in English in the last 30 years. Most of the studies were cross-sectional, and four studies were longitudinal, with follow-up period from one to three years. The studies were analyzed according to the following methodological issues: study design, children's characteristics, noise exposure assessment and blood pressure measurements. The effects of noise on systolic and diastolic pressure were presented in detail.

RESULTS

Studies on aircraft noise had more uniform methodology, indicating a slight tendency towards a positive relationship between aircraft noise exposure and BP in children. The studies on road-traffic noise were methodologically diverse, but compared to aircraft noise studies they showed a more uniform trend in the direction of a positive relationship with systolic BP. The time, place and number of BP measurements, as well as the devices and cuff sizes varied among the studies. Children's age, gender, body composition and ethnicity, and socio-economic status remain the greatest source of diversity in BP values.

CONCLUSIONS

The reviewed studies were methodologically diverse concerning noise exposure assessment, BP measurement, study design and control for confounders. In spite of this, they indicate a tendency toward positive association between noise exposure and children's blood pressure. We recommended strategies that might help researchers adopt similar procedures when measuring BP in future field studies.

Comparative analysis and clinical value of the expression of metalloproteases and their inhibitors by intratumour stromal mononuclear inflammatory cells and those at the invasive front of breast carcinomas

AIMS

Matrix metalloproteases (MMPs) and their inhibitors (TIMPs) play an essential role in the degradation of stromal connective tissue and basement membrane components. The aim of this study was to determine whether the dynamic analysis of these components can help to predict tumour aggressiveness.

METHODS AND RESULTS

An immunohistochemical study was performed using tissue arrays and specific antibodies against MMPs -1, -2, -7, -9, -11, -13 and -14 and TIMPs -1, -2 and -3. More than 5000 determinations on cancer specimens from 124 patients with invasive breast cancer were performed on the tumour centre core as well as on the invasive front. Immunostaining for MMPs/TIMPs on mononuclear inflammatory cells (MICs) was evaluated. To identify specific groups of tumours with distinct expression profiles, data obtained from both MICs populations were analysed by unsupervised hierarchical cluster analysis. When compared with MICs at the invasive front, intratumour MICs more frequently showed expression of MMP-7 and -1 and TIMP-3, but less frequently expression of MMP-9 and -11 and TIMP-2.

CONCLUSIONS

Our data led us to consider the need of further studies in order to identify subsets of MICs and other protein elements of the microenvironment as attractive targets for new therapeutic strategies against cancer.

The role of annoyance in the relation between transportation noise and children's health and cognition

On the basis of this study it cannot be ruled out that the appraisal of the noise affects the association between air and road traffic noise exposure and children's health and cognition. However, the conclusion is limited due to the relatively small group of annoyed children, which may have influenced our group comparisons. Furthermore, the observed relation between annoyance and perceived health is possibly biased due to the fact that both were measured within the same questionnaire. These are the main conclusions of a cross-sectional multi-center study carried out among 2,844 schoolchildren (age 9-11 years) attending 89 primary schools around three European airports. The aim was to investigate how annoyance affects the relation between air and road traffic noise exposure and children's health and cognition. Different, sometimes competing, working mechanisms of how noise affects children's health are suggested. Some effects are supposed to be precipitated through (chronic) stress, while others may arise directly. There is still no theory that can adequately account for the circumstances in which noise will affect cognitive performance.

Associations between chronic community noise exposure and blood pressure at rest and during acute noise and non-noise stressors among urban school children in India

The present study builds on prior research that has examined the association between children's chronic exposure to community noise and resting blood pressure and blood pressure dysregulation during exposure to acute stressors. A novel contribution of the study is that it examines how chronic noise exposure relates to blood pressure responses during exposure to both noise and non-noise acute stressors. The acute noise stressor was recorded street noise and the non-noise stressor was mental arithmetic. The sample consisted of 189 3rd and 6th grade children (51.9% percent boys; 52.9% 3rd graders) from a noisy (n = 95) or relatively quiet (n = 94) public school in the city of Pune, India. There were no statistically significant differences between chronic noise levels and resting blood pressure levels. However, relative to quiet-school children, noisy-school children had significantly lower increases in blood pressure when exposed to either an acute noise or non-noise stressor. This finding suggests that chronic noise exposure may result in hypo-reactivity to a variety of stressors and not just habituation to noise stressors.

Blood pressure of 8-14 year old children in relation to traffic noise at home--results of the German Environmental Survey for Children (GerES IV)

OBJECTIVES

The German Environment Agency carried out its fourth German Environmental Survey (GerES IV) from 2003 to 2006, which was especially for children. 1048 children, 8-14 years of age, were randomly selected from all over Germany. The sample is representative of children in this age group living in Germany with respect to gender, community size, and region.

METHODS

Blood pressure was measured under standardized conditions at clinical study centers. During home visits the children and their parents were asked about leisure activities, housing conditions and environmental factors, including traffic exposure of their homes. Orientating short-term noise measurements were carried out in front of the children's (bed-) room to validate the subjective ratings of the traffic volume (categories: no street, low, moderately, high/extremely high).

RESULTS

With respect to the subjective rating of "type of street" (traffic volume) the lowest blood pressure readings were found in children whose room was facing a street with 'low traffic'. The highest readings were found in the group where the children's rooms were facing a street with a 'high or extremely high traffic' volume. The difference between the two groups was 1.8mm Hg (95% CI: 0.1 to 3.5, p=0.036) for systolic and 1.0mm Hg (95% CI: -0.4 to 2.4, p=0.148) for diastolic blood pressure. With respect to the short-term noise measurements, significant blood pressure increases of 1.0mm Hg (95% CI: 0.3 to 1.6, p=0.004) and 0.6mm Hg (95% CI: 0.1 to 1.2, p=0.025), respectively, were found per 10 dB(A) increment of the noise level.

CONCLUSIONS

The results show that road traffic noise at home is a stressor that could affect children's blood pressure.

Children's annoyance reactions to aircraft and road traffic noise

Since annoyance reactions of children to environmental noise have rarely been investigated, no source specific exposure-response relations are available. The aim of this paper is to investigate children's reactions to aircraft and road traffic noise and to derive exposure-response relations. To this end, children's annoyance reactions to aircraft and road traffic noise in both the home and the school setting were investigated using the data gathered in a cross-sectional multicenter study, carried out among 2844 children (age 9-11 years) attending 89 primary schools around three European airports. An exposure-response relation was demonstrated between exposure to aircraft noise at school (L(Aeq,7-23 h)) and severe annoyance in children: after adjustment for confounders, the percentage severely annoyed children was predicted to increase from about 5.1% at 50 dB to about 12.1% at 60 dB. The findings were consistent across the three samples. Aircraft noise at home (L(Aeq,7-23 h)) demonstrated a similar relation with severe annoyance. Children attending schools with higher road traffic noise (L(Aeq,7-23 h)) were more annoyed. Although children were less annoyed at levels above 55 dB, the shapes of the exposure-response relations found among children were comparable to those found in their parents.

Urban road-traffic noise and blood pressure and heart rate in preschool children

Night time noise exposure has very rarely been used in previous studies on the relationship between community noise and children's blood pressure, although children spend a larger part of their night time sleeping at home than adults. For this reason, we focused on night time noise exposure at children's residences and daytime noise at kindergartens. The aim of this study was to investigate the effects of urban road-traffic noise on children's blood pressure and heart rate. A cross-sectional study was performed on 328 preschool children (174 boys and 154 girls) aged 3-7 years, who attended 10 public kindergartens in Belgrade. Equivalent noise levels (Leq) were measured during night in front of children's residences and during day in front of kindergartens. A residence was regarded noisy if Leq exceeded 45 dB (A) during night and quiet if the Leq was < or =45 dB (A). Noisy and quiet kindergartens were those with daily Leq>60 dB (A) and < or =60 dB (A), respectively. Children's blood pressure was measured with mercury sphygmomanometer. Heart rate was counted by radial artery palpitation for 1 min. The prevalence of children with hypertensive values of blood pressure was 3.96% (13 children, including 8 boys and 5 girls) with higher prevalence in children from noisy residences (5.70%), compared to children from quiet residences (1.48%). The difference was borderline significant (p=0.054). Systolic pressure was significantly higher (5 mm Hg on average) among children from noisy residences and kindergartens, compared to children from both quiet environments (p<0.01). Heart rate was significantly higher (2 beats/min on average) in children from noisy residences, compared to children from quiet residences (p<0.05). Multiple regression, after allowing for possible confounders, showed a significant correlation between noise exposure and children's systolic pressure (B=1.056; p=0.009).

Residential proximity to large airports and potential health impacts in New York State

OBJECTIVE

This study assessed whether residents living near commercial airports have increased rates of hospital admissions due to respiratory diseases compared to those living farther away from these airports.

METHODS

This cross-sectional study included all residents living within 12 miles from the center of each three airports (Rochester in Rochester, LaGuardia in New York City and MacArthur in Long Island). We obtained hospital admission data collected by the NYS Department of Health for all eligible residents who were admitted for asthma, chronic bronchitis, emphysema, chronic obstructive pulmonary disease and, for children aged 0-4 years, bronchitis and bronchiolitis during 1995-2000. Exposure indicators were distance from the airport (< or =5 miles versus >5 miles) and dominant wind-flow patterns from the airport (>75th percentile versus < or =75th percentile), as well as their combinations.

RESULTS

Increased relative risks of hospital admissions for respiratory conditions were found for residents living within 5 miles from the airports (1.47; 95% CI 1.41, 1.52 for Rochester and 1.38; 95% CI 1.37, 1.39 for LaGuardia) compared to those living >5 miles. We did not find positive associations between wind-flow patterns and respiratory hospital admissions among the residents in any airport vicinity. No differences were observed for MacArthur airport using either exposure measure.

CONCLUSION

There is the suggestion that residential proximity to some airports may increase hospital admissions for respiratory disorders. However, there are many factors that could influence this association that may differ by airport, which should be measured and studied further.